——————————————-—————— case report ————————————————————-
SECTIONS Model: Strategizing Technology-Based
Instruction in Physical Therapist Education
Jeff Hawk, MPT, MDE, MBA, E. Anne Reicherter, PT, DPT, PhD, OCS, CHES,
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and Karen L. Gordes, PT, DScPT
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Background and Purpose. The purpose
of this educational case report is to pres-
ent an innovative application of Bates and
Poole’s SECTIONS model9 to promote the
use of web-based videos in a professional
physical therapist education curriculum.
Case Description. This case report pro-
vides a description of the SECTIONS
model and its application to the educa-
tional endeavor using iTunes U©, in ad-
dition to outcomes and recommendations
for further areas of study.
Outcomes. Hybrid learning was effective
and produced the following outcomes
for the Department of Physical Therapy
and Rehabilitation Science (PTRS) at the
University of Maryland School of Medi-
cine: (1) reduced face-to-face class time
by 10%-15%, (2) enabled faculty with
heavy teaching responsibilities to per-
form scholarship and service activities,
(3) allowed lab time to be used for clinical
integration, (4) increased learner respon-
sibility for their own education, and (5)
enhanced relationships between core and
associated faculty by allowing clinicians
Jeff Hawk is the director of instructional tech-
nology at the University of Maryland School of
Medicine, Department of Physical Therapy and
Rehabilitation Science, Baltimore, Maryland.
E. Anne Reicherter is an associate professor of
physical therapy and director of clinical educa-
tion at the University of Maryland School of
Medicine, Department of Physical Therapy and
Rehabilitation Science, 100 Penn Street, Balti-
more, MD 21201. Please address all correspon-
dence to E. Anne Reicherter (ereicherter@som.
umaryland.edu).
Karen L. Gordes is an assistant professor of
physical therapy at the University of Maryland
School of Medicine, Department of Physical
Therapy and Rehabilitation Science, Baltimore,
Maryland.
The authors report no conflicts of interest.
Received June 8, 2012, and accepted March 24,
2013.
Vol 28, No 1, Winter 2014 Journal of Physical Therapy Education 73
access to current information through
PTRS’ online resources.
Discussion and Conclusion. The SEC-
TIONS model provided a stellar frame-
work with which to plan, implement, and
analyze the use of clinical-skill videos
posted to iTunes U©. There was very little
expenditure risk and much reward gained
with implementing this instructional
technology.
Key Words: Hybrid learning, Technology,
Physical therapist education.
BACKGROUND AND PURPOSE
Within the past several years, the mechanism
for delivery of educational content to health
professional learners has undergone vast
changes.1 According to Patel et al,1 “health
professions education is dealing with ma-
jor transformations in light of the changing
nature of the health care delivery system, in-
cluding the use of technology for ‘just in time’
delivery of care, evidence-based practice, per-
sonalized medical care and learning . . .”(p791)
Due to economics, student demand, and the
rapid availability and advances in instruc-
tional technology—the traditional classroom
format of real-time, teacher-driven instruc-
tion has been supplemented with computer-
assisted instruction.2-4
A new common model of instruction is
“hybrid learning.” Hybrid learning combines
traditional classroom instruction with dis-
tance learning via the medium of the Inter-
net.5 The change in the physical distance of
teaching and learning has altered the roles of
both the learner and the instructor, as well as
the pedagogical approaches to support learn-
ing.6
These changes in delivery of education
have not been without controversy. While
many support the use of technologies in edu-
cation, some question if these new methods
are driving the entire educational process.3
There are concerns over whether the rise of
technology in education is stemming from
its abundant use in society as a whole, rather
than from sound educational influences.2
One author questions if we are “using the
latest electronics simply for the sake of using
technology without carefully considering the
pedagogical benefits.”7(p3) Others believe that
technology in education has the potential to
produce independent learners and improve
flexibility of learning by providing an addi-
tional method of delivering content.8
Exploration of the impact of these emerg-
ing methods of delivering physical therapy
educational content is warranted. Specifically,
insight into the impact new technologies are
having on educational processes and student
learning outcomes within an entire education
program is necessary.
The purpose of this case report is to pres-
ent an innovative application of Bates and
Poole’s SECTIONS model9 to promote the
use of web-based videos in a professional
physical therapist education curriculum. A
description of the SECTIONS model, its ap-
plication to the educational endeavor using
iTunes U©10 outcomes, and recommenda-
tions for further areas of study are presented.
SECTIONS Model
The SECTIONS model examines instruc-
tional design from a comprehensive systems
model that includes not only the technology
but the entire educational environment.9 This
model has been used by distance educators,
prior to making the decision to invest in a
particular instructional technology.11 As il-
lustrated in Figure 1, prior to instituting an
instructional technology, the educator uses
“SECTIONS” to examine and consider the
following elements: (1) Students, (2) Ease of
use and reliability, (3) Costs, (4) Teaching
and learning, (5) Interactivity, (6) Organi-
zational issues, (7) Novelty, and (8) Speed.9
The model includes the essential components
and stages of the instructional design process
in a format that is easy to follow. It is decon-
structed into activities, methods, individuals
 involved, what needs to be done, how it will
be achieved, and who is responsible to make
it happen. In addition, the SECTIONS mod-
el can be used for ongoing assessment and
evaluation of the instructional endeavor. The
following material describes and provides
relevant considerations for each factor of the
SECTIONS model.
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Students
Transitioning to a hybrid learning environ-
ment can bring about several changes in the
role of the learner. With hybrid learning, the
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learner must assume more responsibility for
his or her own learning.3 In addition to the
required initiative with added responsibility
for their own learning, students need to be
self-sufficient related to the technology uti-
lized. Though many educators assume that
today’s student is technologically competent,8
this may not always be the case.12
Ease of Use and Reliability
Due to the variability in student competence
with technology and differences in student
comfort regarding the increased distance be-
tween instructor and student, the provision
of learner support is essential for a success-
ful hybrid learning environment.13,14 There
are 2 main types of learner support: technical
support and counseling support. Technical
support includes monitoring the technology
delivery to ensure it is operating efficiently,
as well as offering technical assistance to
the learner.13 If technology is not reliable or
easy to use, the educational process will not
be successful.15 Counseling support includes
methods to improve student communication
skills, techniques to increase interactivity
among classmates and with course materials,
as well as networking with alumni and other
relevant communities.13
Costs
The costs associated with the implementation
of the distance education delivery component
are another important area to consider when
transitioning to a hybrid model of educa-
tion. The cost of implementation should be
framed within the context of the host insti-
tution’s working budget.16 Costs for materials
(software, hardware, etc.), support personnel,
space, and staff should be considered. In ad-
dition, distribution costs, including those as-
sociated with software licenses, and storage
and transmission of materials must be inves-
tigated.15 In addition, reception and delivery
expenditures, like teaching costs and student-
incurred costs (e.g. campus web servers, tu-
ition costs) need to be projected. Conversely,
there can be some cost savings with hybrid
learning. For example, there will be less over-
74 Journal of Physical Therapy Education Vol 28, No 1, Winter 2014
Figure 1. SECTIONS Model: Overview
head costs for classroom space/maintenance
and possibly faculty time.3 Costs also can be
affected by the pedagogical choices of the in-
stitution as the following text describes.
Teaching and Learning
Pedagogical beliefs and practices are signifi-
cant factors to investigate when considering
instructional technologies. The overarching
goal of instructional design is to make learn-
ing more efficient and effective, and the cho-
sen technology should support this goal.18
Instructors should consider their learning
objectives and apply a variety of electronic
educational tools and pedagogical approach-
es to best meet these objectives.19
Due to the ever-changing advances in
instructional technology, faculty often need
ongoing support for technology-based edu-
cational initiatives. According to McIsaac
and Craft,20 teachers are often expected to
integrate technologies . . . into their classes
when they have had little experience doing
so.”(p41) If curricular materials that emphasize
technology are to be helpful, instructors must
be motivated to learn enough to comfortably
use the technology for course activities. Be-
audoin21 argues that distance education’s fu-
ture is dependent on whether or not faculty
accept these new forms of instruction.
However, faculty often have limited ad-
ministrative and technical support, and may
perceive less respect for their efforts related
to the distance education component of hy-
brid learning compared to traditional class-
room instruction.22 Faculty members who
feel supported may be more likely to embrace
distance education efforts; an encouraging
faculty development environment is critical
to success. Instructors need assistance with
designing online activities that support their
learning objectives.23
Interactivity
Another key factor to consider is the realistic
level of interactivity that is required to achieve
learning outcomes. Synchronous learn-
ing, when an instructor is actively engaged
with the learner in real time, is traditionally
thought of as the ideal state of interactivity.
However, due to the possible lapse of atten-
tion during class or possible absence from
class, this may not be the case.24
In contrast, asynchronous learning, when
structured properly, can have many benefits.
In fact, asynchronous learning may be more
interactive than a synchronous learning envi-
ronment. Berge25 suggests that students’ roles
change in hybrid learning courses as they
move “from passive receptacles for hand-
me-down knowledge to constructors of their
own knowledge.”(p4) Asynchronous technolo-
gies can increase student responsibility in the
learning process, foster active learning, and
assist in developing skills necessary for the
student to engage as a life-long learner.8
Organizational Issues
Organizational factors are one of the most
important considerations for longevity and
success of technology-mediated learning in
hybrid and distance learning environments.26
According to Beaudoin21 the paradigm shift
of moving away from the traditional class-
room may require “infrastructure changes,
policy formulation, institutional commit-
 ment, strategic planning, resource allocation
and leadership focused on such efforts.”(p100)
Organizations must systematically analyze
the demands of their institution and develop
appropriate organizational support to ensure
effective implementation.21
Novelty
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Another consideration is the novelty of the
technology. Although newer computer sys-
tems and applications have more robust at-
tributes, maintaining up-to-date resources
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is not without its challenges.27 For instance,
existing operating systems might be too out-
dated to support new programs and might
need to be upgraded as well. There frequently
are additional costs for maintenance and
upgrades.27 According to one study, the cost
for upgrading software or courseware can re-
quire an additional 10% of the initial cost.15
Newer systems require technical support to
monitor and address glitches, and newer op-
tions may require more administrative and
instructional support due to the user’s learn-
ing curve.15
Speed
Implementation speed is a key factor to con-
sider, as adding technology into a curriculum
will likely increase administrative and faculty
preparatory time and should be accounted
for in the preplanning phase.3,15 In addition,
institutional approval may be required prior
to upgrades or installation of equipment. On
the educational side, the awareness that user
training is likely necessary should be incor-
porated into start-up planning.28 Specifically,
Rumble17 indicates that faculty, students, and
technical support staff will need training pri-
or to implementation, and it will vary based
on the user’s prior level of experience.
CASE DESCRIPTION
Our large, long-established professional
physical therapist program in the Depart-
ment of Physical Therapy and Rehabilitation
Science (PTRS) is housed at the University of
Maryland School of Medicine. During cur-
ricular review, our program identified several
challenges related to efficiency, student learn-
ing outcomes, and faculty productivity. We
identified that our students spent a significant
portion of their day in lengthy psychomotor
skills laboratories (labs), affecting faculty
productivity and limiting time available for
student out-of-class study and respite.
Upon examining the cost benefit of these
lengthy in-class sessions, several concerns
became evident. Despite the length of on-
campus lab sessions, there was limited time to
address higher-level psychomotor objectives,
Vol 28, No 1, Winter 2014 Journal of Physical Therapy Education 75
such as correcting student skills, modify-
ing techniques, or focusing on clinical inte-
gration. Faculty spent the majority of these
sessions addressing lower-level skill acquisi-
tion and learning objectives. Also, due to the
number of lab instructors required to manage
our large student body, students reported in-
consistency of basic skill instruction among
lab instructors. Subsequently, inconsisten-
cies in student performance were noted in
psychomotor testing and even during clinical
internships. Furthermore, the high percent-
age of time faculty spent in the classroom re-
sulted in challenges to faculty’s ability to meet
institutional service and scholarship require-
ments.
After considering these challenges, a hy-
brid model for teaching psychomotor skills in
the Basic Sciences 3 (BS3) course was identi-
fied as a potential solution. BS3 is offered in
the third semester of the curriculum and is
the first clinical application course. As part of
the course, students develop physical therapy
skills for screening, examination, and inter-
ventions. Since the course is administered in
a block format schedule, daily for 3 months,
student and faculty preparedness is impera-
tive.
The hybrid learning initiative included the
creation of a multimedia video library com-
bined with onsite lab sessions. The videos
were made accessible on the PTRS iTunes U©
website, a section of the iTunes store where
users can download free educational content
from many universities.10 Examples of video
topics included range-of-motion assessment,
manual muscle testing, and joint special tests.
The purpose of the videos was to provide in-
structional material at the foundation level,
as well as to provide students an opportunity
to practice psychomotor skills prior to face-
Figure 2. SECTIONS Model: Application
Is iTunes U© an appropriate technology medium for delivery of basic instruction
on foundational psychomotor skills?
to-face lab attendance. Students were advised
that content included in the videos would
not be presented again in class and that they
were expected to be able to demonstrate the
skills at the beginning of the lab session. With
the transition to the hybrid learning, faculty
rewrote learning objectives to identify the
lower-level components of learning that were
to be met with the online component and the
higher-level tasks that were to be met in the
face-to-face instruction.
Labs were then structured to allow for
higher-level psychomotor tasks (eg, skill
modification and advancement, clinical in-
tegration). This contrasted with our former
traditional teaching model, in which faculty
demonstrated skills at the onset of lab to the
entire class and then had the students model
what they had just observed.
For example, in the past, when instructing
goniometry at the shoulder joint, an instruc-
tor demonstrated how to conduct the test in
front of the entire group of students. The stu-
dents would then perform this skill in pairs,
with faculty roaming the classroom and pro-
viding feedback. With the hybrid model, stu-
dents independently watch a preclass video of
a clinician performing shoulder goniometry.
Then, during class, students immediately di-
vide into small groups and demonstrate the
skills. Emphasis is on critique of psychomo-
tor performance and the application and po-
tential modification of these skills through
the use of patient clinical scenarios.
The following sections provide a descrip-
tion of PTRS’ use of the SECTIONS model
to plan for and analyze the use of iTunes U©
instructional technology for the BS3 course
in our professional physical therapist cur-
riculum (Figure 2).
 Students
Student demographics related to the comfort
level and use of technology is the first com-
ponent to consider in the SECTIONS model.
There were approximately 55 students in the
class during this initiative. Our student popu-
lation is made up of individuals primarily in
the mid-20s age range. Though there were
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several second-career students (approximate-
ly 5% of the class); physical therapy was the
first career for a large majority of students. A
bachelor’s degree is required to enter the pro-
gram. Approximately one-third of students
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filter into our program from other University
of Maryland institutions, many of which use
a web-based course management system. In
addition, as with all student populations, our
students have diverse learning styles; some
auditory, some visual, and some kinesthet-
ic.29 Therefore, no single learning style can be
identified with our student body.
It is important to recognize that, although
there was availability for web-based course
management at their undergraduate institu-
tions, not all students had participated in
courses that used a web-based course system
to the extent encountered in our program.
Based on class survey, approximately 10% of
students had not had exposure to any course
management system prior to entering our
program. Conversely, in the previous 2 se-
mesters in the curriculum, all of the students
had been accessing the course management
system for course documents and grades
within our program.
Though our students frequently use tech-
nology for social media, they are generally
not “digitally native” students when it comes
to education. Our students continued to
purchase hard copies of their textbooks, de-
spite the option to obtain an e-text version,
and preferred to take hand-written notes on
printouts of their instructors’ class slides.
Ease of Use
Prior to PTRS’ decision to increase its use
of hybrid learning, the campus had already
taken many steps to transition from a cam-
pus-based university to a dual-mode uni-
versity—one that offered both traditional
and distance models of educational delivery.
Through the web-based course management
system, library, and human resources, the
university had generated technology sup-
port services for students, faculty, and educa-
tional support staff. In addition, the campus
had acquired the iTunes U© platform. The
prior implementation of both the technol-
ogy framework and adjunct services paved a
path for easy implementation of instructional
technology for the PTRS department. In an
effort to reduce face-to-face class time, as well
76 Journal of Physical Therapy Education Vol 28, No 1, Winter 2014
Figure 3. Roles of Instructor and Instructional Technologist in Video Production
and iTunes U© Administration
as provide flexibility and convenience for in-
structors and students, we selected iTunes U©
as the source for our asynchronous technol-
ogy to deliver media files.
iTunes U© is a simple, dependable tech-
nology and is accessible from any location
that has high-speed internet access.10 Fur-
ther, iTunes U© has the ability to be viewed
on multiple operating systems and mobile
technology platforms; thus, a unified system
by students and faculty was not needed. In
addition, PTRS provides multiple networked
computer stations with capabilities to access
iTunes U© for use by students and faculty.
However, the opportunity to view multime-
dia files wirelessly via laptops, smart phones,
or tablets was challenged because of the
patchy wireless system within our building.
To ease any anxiety about implementa-
tion, PTRS’ instructional technology (IT)
staff offered training sessions to both students
and faculty users on how to best use the mul-
timedia tools. PTRS IT staff was available for
on-campus support during normal business
hours during the transition phase and imple-
mentation process, as well as to provide on-
going technical support. The campus library
provided educational technology classes as
well.
Costs
Cost is an essential component to the imple-
mentation of any new program, and cost
analysis is essential when determining the
potential success or failure of using instruc-
tional technology. For PTRS, new directs
costs were not a factor; the academic institu-
tion in which the department is housed had
previously implemented infrastructure for
iTunes U©. Though PTRS had existing tech-
nology staff on payroll, there were indirect
costs in the form of time.
As Figure 3 demonstrates, the efforts
overlapped. The instructor was responsible
for storyboarding, scripting the video con-
tent, and writing learning objectives associ-
ated with the video. The instructor and the
instructional technologist together would
stage and film the video. Student volunteers
served as patients in the videos, with the con-
tent expert faculty member providing the in-
struction. Postproduction editing was a joint
endeavor between the faculty member and
the instructional technologist. Last, conver-
sion to an iTunes U©-compatible format and
the administration of the PTRS iTunes U©
website content area were the responsibility
of the instructional technologist.
In addition to time costs incurred by tech-
nology staff, the cost of time to learn the new
technology, develop online instructional ma-
terial, and redesign current labs by faculty
should not go unnoticed. From an investment
perspective for faculty, these indirect costs
do not carry on to subsequent years, as the
content selected for delivery via multimedia
resources was unlikely to change from year
to year. The exception to this would be the
faculty member who acts as the block leader.
This person is responsible for reviewing the
media content annually to determine rel-
evance, accuracy, etc. based on course evalu-
ations and any new/updated content for the
upcoming course. The indirect time costs for
technology staff would, however, continue as
there is a need to continuously monitor that
the system is working and support issues that
students and faculty may have.
Given that the institution had already as-
sumed many of the infrastructure costs as-
sociated with a web-based distance education
environment, PTRS did not have many of
the traditional costs associated with trying
to initiate an online learning environment.
 This meant that PTRS could expand its hy-
brid model of education with very little initial
expenditure.
Teaching and Learning
Use of the hybrid model for teaching psy-
chomotor physical therapy skills had several
planned pedagogical and curricular benefits.
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First, the use of multimedia videos, combined
with traditional in-lab instruction, would
enhance student learning and retention of
information—as it accesses multiple intelli-
gences, allowing for the benefits for auditory,
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visual, and kinesthetic learning.29 The use of
videos was ideal for teaching these types of
skills; students just mimic the demonstration
style used in traditional physical therapy edu-
cation.
Second, due to the multistep learning
structure, scaffolding of new learning would
occur. This layering method of education
has been shown to be effective in enhancing
learning retention, as the student has the op-
portunity to construct and integrate his or her
own knowledge.30,31 Third, the method uses
an apprenticeship model of pedagogy.32-33
The experienced lab instructors’ mentoring
during the clinical integration lab should
enable students to achieve a level of compe-
tence not attained with independent learning.
Finally, student outcomes benefits would be
anticipated. Since there was a timeless video
capture of the skill to be learned, there would
be a gold standard of ultimate correct perfor-
mance.
In analyzing teacher experience, the PTRS
faculty had varying levels of comfort and
competence with instructional technology.
They spanned the comfort spectrum from
early adopters to slow or non-adopters. There
were several initiatives to assist faculty in
order to make this venture successful. First,
PTRS had a dedicated staff member spe-
cifically assigned to assist with instructional
technology. Second, there would be a step-
wise training and implementation plan for
use of the videos. Training sessions and on-
line tutorials focused on iTunes U©, as well
as teaching strategies to ensure that learners
play an active role in their educational pro-
cess.
In addition, experienced faculty who
have been through the process would men-
tor those that had not. Last, the campus had
an e-Learning Committee that supports and
develops faculty efforts at online delivery and
shares best practices.
Interactivity
Asynchronous technologies foster active
learning and assist students in the devel-
opment of life-long learning skills, both of
Vol 28, No 1, Winter 2014 Journal of Physical Therapy Education 77
which are goals of our physical therapist
education program.35 Based on the theory
of constructivism,33 iTunes U© provides stu-
dents the opportunity to view educational
content at their discretion; thereby, providing
students with the control to select the most
opportune time to engage in learning. Once
the videos are downloaded, students also can
pause and replay them. This provides viewers
the ability to process information at their own
pace and to review instruction several times,
unlike instruction in a typical classroom set-
ting. Interaction with course materials, such
as textbooks, mock patients, and classmates
in study groups, also can occur. The intent of
providing foundational course material prior
to onsite labs was to provide more opportu-
nity for higher levels of clinical integration
when students and faculty met face to face.
Organizational
Beaudoin’s21 strategy of incremental change
would be paramount in implementing a
successful hybrid model that met little re-
sistance. The university has dedicated avail-
able resources to support hybrid-learning
initiatives. However, without the support of
PTRS administrators, a change of this mag-
nitude would be unsuccessful. There were
already PTRS initiatives in place to increase
technology use in order to improve time and
cost efficiencies. Additionally, the leader-
ship approach was aligned with policies that
enhanced faculty buy-in. Extensive hybrid
learning had already been used in another
PTRS educational program, which allowed
for more rapid implementation of the iTunes
U© instructional technology in the profes-
sional physical therapist program.
Novelty and Speed
Though iTunes U© was novel, many students
and faculty had reported use of iTunes© for
music and nonacademic video downloading.
Thus, a short learning curve was anticipated
for users. Since the university already had an
iTunes U© presence, all hardware and soft-
ware components had been procured or were
available as a campus-based resource through
the university’s Center for Information Ser-
vices. Due to its technological adaptability,
iTunes U© had the flexibility for use on mul-
tiple current mobile platforms and operating
systems. Subsequently, there was little expec-
tation users would need the time to learn or
adapt to a new operating system.
Another advantage for instituting this in-
structional technology was that it could be
quickly instituted since the beginnings of the
multimedia library existed from some previ-
ous class videotaping efforts. On the other
hand, additional time to script and record ad-
ditional videos would be needed.
OUTCOMES
Evaluation and Assessment of the
Implementation of iTunes U© Videos
To gather information on the success of
implementing psychomotor skills videos via
iTunes U©, PTRS obtained feedback from
all key stakeholders. These stakeholders in-
cluded: students, faculty (both core and as-
sociated), and instructional technology (IT)
staff. On the course evaluation, students (n =
37) provided feedback on how they used one
of the online videos included in the course.
A total of 30 students reported viewing the
video prior to the in-class lab session, 24
viewed the video after the in-class lab session,
25 viewed the video more than once, and 30
students rated the video as very useful.
These results suggest that students used
the videos to prepare for lab sessions, as well
as to fine tune or refresh their skills after
on-campus lab sessions occurred. Further,
students had multiple requests for expan-
sion of the multimedia library. In fact, many
students actually initiated making additional
videos for future courses and cohorts based
on what they felt was needed for learning the
skills. At the onset of the initiative, the total
number of online videos available for student
learning was 75. As of the writing of this pa-
per, the library has grown to include over 200
videos.
Feedback by lab instructors also identified
an appreciation for the ability to view course
content prior to their direct interactions with
students. In particular, associated faculty felt
more confidence in teaching the skills in con-
cert with curricular preferences and being
able to provide more cohesive instruction. All
faculty reported greater satisfaction in teach-
ing the higher-level critical thinking that the
new method provided.
In addition, lab instructors were able to re-
duce the total number of hours provided for
face-to-face instruction for certain psycho-
motor content areas. Since basic demonstra-
tion of psychomotor skills occurred prior to
the face-to-face lab session, many labs were
reduced from 3-hour lab sessions to 2-hour
lab sessions. Although some lab sessions re-
mained 3 hours in length, the reduction in
time spent on basic instruction allowed for
these labs to incorporate patient cases rela-
tive to the psychomotor skill being covered.
Regarding student performance out-
comes, psychomotor assessments during the
hybrid learning were compared to assess-
ments made when content was delivered by
the traditional model. Overall, with the use
of the videos as a replicable standard, there
 were fewer inconsistencies in psychomotor
grading of the skills by testers, and student
performance did not differ between the 2 de-
livery methods. Thus, there is some evidence
to suggest that the videos improved stan-
dardization of testing and assisted in the ac-
curate reinforcement of student skills as time
elapsed from face-to-face sessions.
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PTRS’ IT staff enjoyed the collaborative
process with faculty in creating the videos.
The centralization and the web-base of the
course media resources has resulted in fewer
WnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 03/24/2023
IT requests from students, allowing more
time for other tasks. Similar to faculty, the
initial 1-year commitment was challenging,
but subsequent years have allowed faculty to
move the focus to other courses in order to
implement similar practices.
Finally, cost effectiveness is an essential
barometer for evaluation and assessment.
By having students learn the psychomotor
skills prior to class, 6 on-campus lab sessions
were able to be shortened by 1 hour. This
enabled a lab instructor staffing cost savings
of $1,200 for the BS3 course. In terms of the
hardware and software needed to implement
the distance portion of the hybrid model, the
university had assumed the start-up costs.
Initially, faculty and IT staff needed to pro-
vide an investment of time to script, film, and
help with editing the content of the videos.
For example, a 5-minute video clip took a
faculty member and an IT member 1 hour
and 15 minutes to complete. By using the
overlapped workload delineation illustrated
in Figure 3, the time cost of that video clip
production was $70 ($40/hour for faculty and
$30 for an IT specialist). Video creation was a
1-time investment, as the faculty chose video
content that did not have to be frequently
changed over time. Subsequently, the cost of
faculty time did diminish considerably once
the videos were complete. In addition, course
instructors reported providing less time tu-
toring during office hours to clarify instructor
inconsistency or student practice error. This
allowed faculty more time for other teaching,
scholarship, or service activities.
In summary, hybrid learning was effective
in meeting the following PTRS departmental
goals: (1) reducing face-to-face class time by
10%-15%, (2) enabling faculty with heavy
teaching responsibilities to perform scholar-
ship and service activities, (3) allowing lab
time to be used for clinical integration, (4)
increasing learner responsibility for his or her
own education, and (5) enhancing relation-
ships between core and associated faculty by
allowing clinicians access to current informa-
tion through PTRS’ online resources.
78 Journal of Physical Therapy Education Vol 28, No 1, Winter 2014
DISCUSSION AND CONCLUSION
There are certain challenges in the form of
time and resources for both faculty and stu-
dents in the traditional, face-to-face model
of learning. Developing creative ways to use
current technologies to supplement the tradi-
tional model of learning may be one method
to address the time constraints faced by both
students and faculty in today’s learning envi-
ronment. PTRS implemented and evaluated
a hybrid learning model using iTunes U©
in an attempt to address time efficiency is-
sues for both students and faculty. Using the
SECTIONS model prior to implementation,
we were able to identify several advantages
for enhancing the hybrid model in our pro-
gram. PTRS had significant infrastructure,
onsite IT support, and a student popula-
tion with previous exposure to 21st-century
educational technologies—all of which al-
lowed for a smooth transition to the use of
iTunes U© (without significant costs). This
form of educational enhancement addressed
specific curricular and program needs, as
well as cultivated student independence and
life-long learning skills required for future
physical therapist professionals. Due to the
ever-changing learning needs of the student
body, the practice of physical therapy, and
technologies available, it will be important
to continuously assess the use of this instruc-
tional technology.
Therefore, areas for future study and de-
velopment include: monitoring student use
and outcomes, expanding faculty training,
and application in clinical settings. To gain
more information and actual student use of
the online videos, user-frequency data can be
collected. Based on these data, better corre-
lations between online viewing and ultimate
psychomotor performance can be performed.
The access and use of the videos could be ex-
panded to the clinical setting in order to re-
ceive feedback about student performance
with real patients.
There are several areas where PTRS can
improve in terms of faculty support for online
initiatives. First, allowing faculty time for de-
velopment of the online component of their
course and establishing goals in a faculty’s
yearly development plan that reward distance
learning efforts. At the time of this project,
there were no methods to calculate workload
for time dedicated to distance education.
Thus, some faculty were reluctant to redis-
tribute a significant portion of time to de-
veloping online curriculum. Since that time,
allocation of credit in teaching workload has
been added for online teaching. Second, en-
courage faculty to participate in professional
development designed to promote and de-
velop e-learning endeavors.
In conclusion, the idea of expanding the
hybrid-learning model for PTRS’ profes-
sional physical therapist program evolved as
a potential solution to several departmental
challenges. The SECTIONS model provided a
stellar framework with which to plan, imple-
ment, and analyze the use of clinical skill vid-
eos posted to iTunes U©. There was very little
expenditure risk and much reward gained
with implementing this instructional tech-
nology.
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